CAPTURE: a multinational, cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries

Abstract

Background There is a paucity of global data on cardiovascular disease (CVD) prevalence in people with type 2 diabetes (T2D). The primary objective of the CAPTURE study was to estimate the prevalence of established CVD and its management in adults with T2D across 13 countries from five continents. Additional objectives were to further characterize the study sample regarding demographics, clinical parameters and medication usage, with particular reference to blood glucose-lowering agents (GLAs: glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors) with demonstrated cardiovascular benefit in randomized intervention trials. Methods Data were collected from adults with T2D managed in primary or specialist care in Australia, China, Japan, Czech Republic, France, Hungary, Italy, Argentina, Brazil, Mexico, Israel, Kingdom of Saudi Arabia, and Turkey in 2019, using standardized methodology. CVD prevalence, weighted by diabetes prevalence in each country, was estimated for the overall CAPTURE sample and participating countries. Country-specific odds ratios for CVD prevalence were further adjusted for relevant demographic and clinical parameters. Results The overall CAPTURE sample included 9823 adults with T2D (n = 4502 from primary care; n = 5321 from specialist care). The overall CAPTURE sample had median (interquartile range) diabetes duration 10.7 years (5.6–17.9 years) and glycated hemoglobin 7.3% (6.6–8.4%) [56 mmol/mol (49–68 mmol/mol)]. Overall weighted CVD and atherosclerotic CVD prevalence estimates were 34.8% (95% confidence interval [CI] 32.7–36.8) and 31.8% (95% CI 29.7–33.8%), respectively. Age, gender, and clinical parameters accounted for some of the between-country variation in CVD prevalence. GLAs with demonstrated cardiovascular benefit were used by 21.9% of participants, which was similar in participants with and without CVD: 21.5% and 22.2%, respectively. Conclusions In 2019, approximately one in three adults with T2D in CAPTURE had diagnosed CVD. The low use of GLAs with demonstrated cardiovascular benefit even in participants with established CVD suggested that most were not managed according to contemporary diabetes and cardiology guidelines. Study registration NCT03786406 (registered on December 20, 2018), NCT03811288 (registered on January 18, 2019).

Cardiorenal outcomes with sodium/glucose cotransporter-2 inhibitors in patients with type 2 diabetes and low kidney risk: real world evidence

“…For example, the prevalence of established CVD in these CVOTs varied between 40.6% in the DECLARE-TIMI 58 trial [ 31 ], 65.6% in the CANVAS program [ 4 ], and the entire sample populations of EMPA-REG OUTCOME and VERTIS CV [ 1 , 3 ]. In comparison, our propensity-matched cohort had only 29.3% baseline prevalence of established CVD (Table 1 ), similar to other cross-sectional reports of the general T2D population in different countries [ 30 , 32 , 33 ]. Kidney-wise, baseline mean eGFR of the participants in our analysis was 88.3 ml/min/1.73 m 2 compared with 74.2–77.2 ml/min/1.73 m 2 in the EMPA-REG OUTCOME, CANVAS program and VERTIS CV [ 2 – 4 ], and 85.3 ml/min/1.73 m 2 in the DECLARE-TIMI 58 [ 6 ].…”

Contemporary (2019) prevalence of cardiovascular disease in adults with type 2 diabetes in Brazil: the cross-sectional CAPTURE study

“…Within the subtypes of CVD, CHD was the most prevalent one, with CHD, heart failure, cerebrovascular disease, and PAD being more prevalent compared with other subtypes (carotid artery disease, cardiac arrhythmia and thromboembolic disease), albeit at lower rates than ASCVD, as ASCVD is a combination of several CVD subtypes. The prevalence of all CVD subtypes were higher in the Brazil sample compared with the multinational sample, with the exception of carotid artery disease, which was lower in the Brazil sample than in the multinational sample (3.4% vs 8.4%) (14). It is possible that patients recruited to CAPTURE in Brazil had higher numbers of complications compared with the multinational sample, as the Brazilian centers carrying out research tended to serve complex patients.…”

“…Analysis of data for the CAPTURE Brazil sample demonstrated that almost one in two adults (43.9%) with T2D had established CVD, which is a higher prevalence than that seen in the overall multinational sample (34.8%) (14).…”

“…The study design of CAPTURE, a multinational, non-interventional, cross-sectional study conducted across 13 countries, has previously been described (14). The current manuscript explores the data for the CAPTURE study sample in Brazil.…”

“…The CAPTURE study (NCT03786406, NCT03811288) was a non-interventional study using a standardized methodology to assess the prevalence of CVD among adults with T2D in 13 countries across the world (14). Here, we report the CVD prevalence data for Brazil.…”